A qualitative study of the fidelity of implementation of an evidence-based healthy relationships program
Doctor of Philosophy
Dr. Peter Jaffe
This case study examined the factors that are important to successful implementation of a violence prevention program, The Fourth R Program, in one school district in a large, urban city in Alberta, Canada. Teachers, school administrators, and a school district program coordinator participated in a structured interview. Students in Fourth R classes participated in a focus group. The interview focused on potential facilitators and barriers to implementation and perspectives on fidelity and adaptation of the Fourth R program in the classroom. The focus group focused on students’ experience, responsiveness and self-reported knowledge of program content. Teachers completed a survey at the end of teacher training to assess efficacy and confidence in delivering the program and an implementation survey to assess program fidelity. Based on survey and interview data, teachers were classified as high or low implementers. The interviews were transcribed and coded to identify the similarities and differences among the responses as well as themes that cut across participants. The results indicated that characteristics related to the program, the teacher, and the broader school environment influenced implementation fidelity. The Fourth R’s standardized manual and content made for a high level of receptivity by all teachers which facilitated implementation. High implementers uniquely noted the programs’ focus on teaching students about healthy relationships as a facilitator of implementation. School administrator support emerged as an important facilitator to implementation fidelity, but the quality of support differed for high and low implementers. Barriers to fidelity of implementation included difficulty in meeting the time frames for program lessons, external influences and school disruptions, and implementation experience. Implementing role plays was a challenge for all teachers, but low implementers expressed more discomfort in the methodology than high implementers. School administrators and school district program coordinator echoed many of the same themes as did teachers. Students in classrooms that received more of the Fourth R program expressed more positive classroom experience and responsiveness to the curriculum but not necessarily more perceived knowledge of health outcomes. Implications for strengthening the connection between research and practice in the delivery of prevention programs in schools are discussed.
Chiodo, Deborah G., "A qualitative study of the fidelity of implementation of an evidence-based healthy relationships program" (2017). Electronic Thesis and Dissertation Repository. 4405.